Healthcare Provider Details

I. General information

NPI: 1629023494
Provider Name (Legal Business Name): SANDRA B REED MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 12/28/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1365 CLIFTON RD NE FOURTH FLOOR
ATLANTA GA
30322
US

IV. Provider business mailing address

977 CLIFTON RD NE
ATLANTA GA
30307-1285
US

V. Phone/Fax

Practice location:
  • Phone: 404-778-3401
  • Fax: 229-226-8232
Mailing address:
  • Phone: 229-224-0249
  • Fax: 229-226-8232

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number31392
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: